Use of the Serratus Anterior Muscle Flap for Postoperative Empyema - A Single Center Experience with 25 Consecutive Cases
P.V.H. Boţianu, A.M. BoţianuOriginal article, no. 5, 2013
Objective: The aim of this study is to analyse the possibilitiesand the results of using the serratus anterior muscle flap duringreoperations in patients with a complicated course after majorgeneral thoracic procedures.Material and Methods: We performed a retrospective study on25 consecutive patients operated in a single center between01.01.2002-01.01.2012, in whom we used the serratus anteriormuscle flap during complex thoracomyoplasty procedures forpostoperative empyema. In all cases the serratus anterior wasmobilized keeping both the thoraco-dorsal branch and thelateral thoracic vessels intact. The following parameters werefollowed: mortality rate, morbidity rate, hospitalization,viability of the flap and the functional status of the patients at3 months after surgery.Results:We encountered one postoperative death (4%) and onerecurrence of the intrathoracic suppuration (4%). Intensive careunit hospitalization ranged between 1-9 days, with a median of2 days. Overall postoperative hospitalization ranged between8-87, with a median of 34 days. We have encountered no post-operative flap necrosis. At 3 months after surgery, 92% of thesurvivors returned to a normal life. The type of the firstthoracotomy incision (postero-lateral versus antero-lateral) hadno statistically significant impact on the outcome of thepatients â€" hospitalization or rate of local complications(p 0.05).Conclusions: As a pure muscular flap, the serratus anterior isextremely useful to treat infectious complications aftergeneral thoracic surgery procedures. It can be used duringthoracomyoplasty procedures with an acceptable mortalityand morbidity and with good functional results.
